Individual provider Active NPI

Jody William Ames, D.D.S.

  • Dentist
  • Xenia, OH
National Provider Identifier
1053535534
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30020527 Issued in OH
Practice address
1195 W 2ND St
Xenia, OH 45385-3702
Phone
(937) 372-8502
NPI assigned
Apr 13, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30020527 OH Primary

Addresses

Primary practice location

1195 W 2ND St
Xenia, OH 45385-3702

Mailing address

1150 W Locust St
Suite 400
Wilmington, OH 45177-2572
Phone (937) 382-6971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160908001129 OH Order and Referring Only - DentistPractitioner - Dentist 7618263237

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30020527OHMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053535534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 W LOCUST ST",
            "address_2": "SUITE 400",
            "city": "WILMINGTON",
            "state": "OH",
            "postal_code": "451772572",
            "telephone_number": "937-382-6971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1195 W 2ND ST",
            "city": "XENIA",
            "state": "OH",
            "postal_code": "453853702",
            "telephone_number": "937-372-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMES",
        "first_name": "JODY",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30020527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Xenia, OH

Sources for this page

Verify at the official NPI Registry.